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(Circulation. 2007;116:II_820.)
© 2007 American Heart Association, Inc.

Thromboembolism, Stroke, ECG

Abstract 3615: Patent Foramen Ovale and Migraine: a Cross-Sectional Study from the Northern Manhattan Study (NOMAS).

Tatjana Rundek¹; Mitchell S Elkind²; Marco R Di Tullio²; Emmanuel Carrera²; Zhezhen Jin²; Ralph L Sacco³; Shunichi Homma⁴

¹ Univ of Miami, Miami, FL
² Columbia Presbyterian Med Ctr, New York, NY
³ Univ of Miami, Miami, FL
⁴ Columbia Presbyterian Med Ctr, New York, NY

Background and Objective A causal relationship between patent foramen ovale (PFO) and migraine has been hypothesized, and improvement of migraine frequency and severity after percutaneous PFO closure has been reported in some studies. Population-based data on the relationship between PFO and migraine are lacking, however. The objective of this study was to examine the association of PFO and migraine among stroke-free individuals in an urban, population-based multiethnic cohort.

Methods As a part of the ongoing Northern Manhattan Study (NOMAS), 1101stroke-free subjects were assessed for self-reported migraine. The presence of PFO was assessed by transthoracic echocardiography with contrast injection. The mean age of the group was 68.7±10.0 years; 58.1% women; 48.4% Caribbean Hispanic, 24.2% white, 25.5% black, 1.9% other race-ethnicity.

Results In the overall group, the prevalence of migraine was 16.2%, and the prevalence of PFO was 14.9%. Migraine was significantly more frequent in women (128/640, or 20.0%) than in men (50/461, or10.9%; p<0.001). Migraine was significantly more frequent in Hispanics (104/533, or 19.5%) than in whites (36/266, or 13.5%; p= 0.04) or blacks (35/281, or 12.5%; p=0.01). The prevalence of PFO was not significantly different between subjects who had migraine (26/178, or 14.6%) and those who did not (138/923, or 15.0%; p=0.9). Increasing age was associated with lower prevalence of migraine in both subjects with a PFO (odds ratio 0.94, 95% Confidence Interval 0.90 – 0.99 per year) and those without it (OR 0.97, 95% CI 0.95– 0.99 per year). No differences were observed on the relationship between PFO and migraine for diabetes, hypertension, cigarette smoking and dyslipidemia.

Conclusion PFO was not associated with self-reported migraine among stroke-free subjects in this multiethnic population-based study. The causal relationship between PFO and migraine remains uncertain, and the role of PFO closure among unselected patients with migraine remains questionable.

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